No more tubes!

Sorry about the somewhat-delayed update, but the entire day has been so hectic that I haven't had a chance to post the good news:

No more tubes!

While taking a shower this morning (Monday was the first time that Judy did take an actual shower), Judy's NG tube (the one that goes into the nose and down to the stomach to siphon off fluids) somehow slipped out. I was teaching at TTU this morning, but what our friend Kathy O., who was staying with Judy at the time, told me things were not pretty. The nurses made several attempts to reinsert the tube, but it was apparently very painful and they had to abort the maneuver.

But all this may really have been a blessing in disguise: It turns out that Judy's intestinal system is starting to work again, and before mid-afternoon she had two bowel movements, without any pain. What that means is that the colon resection is working! There is added nausea right now because the "vile bile" as I called it has to be processed by her own system instead of being siphoned off, and she has been kinda puky this afternoon and evening.

Around 5:00 p.m. Dr. Phillips stopped by, in between surgeries. He was extremely happy with her progress and ordered to start a liquid drip diet, the first nourishment since last week Wednesday when she started the prep for the surgery. She is also allowed broth and popsicles, but two spoonfuls was enough. It will take a while to start up the system again after a weeklong shutdown. But I think we may have started that whole nutrition path a little earlier than we would have without the "accident" in the bathroom.

And talking about tubes: The catheter is gone, too!

Dr. Phillips said that Judy quite likely will be discharged on Thursday, although there can always be hickups.

Judy may be a little groggy right now, but she is a happy camper since she knows that things are coming along.

Thank you all for reading and staying involved!

Jürgen

A quiet Sunday evening at the hospital

After having been gone for 36 hours I am back with Judy in the hospital. When I left, she was in ICU--and when I came back, she was in her room (#527), looking and sounding 150% better than when I left. What a change!

I have just gone through the notes that Judy's fabulous caretakers have left in our little diary. It was Judy's idea to have such a booklet so that whoever is sitting with her has an idea of who has been by to visit, what treatment was performed, what else has happened.

While I was in Palo Duro where so many of you showed your concern and support for Judy, friends and family dropped by the hospital and paid Judy a visit. Now the little woman is all worn out, and I have urged her to nap. She has received an additional two units of blood as a precautionary measure since her blood count was a bit low, but the nurse did not indicate that there is any kind of internal bleeding or other complication. Judy can now drink water, tea, and apple juice, and she can actually sip it instead of sucking it out of a small sponge. They're all little steps, but they appear significant.

I myself feel a tad tired after the drive and working the race, which was quite a success. In my racers' meeting I made clear that I was just a stand-in for Judy, who was supposed to be the head referee. They all cheered for her when I told them that Judy has every intention to be back next year. The Photo shows the lads at the hillclimb on Saturday. So, I better call it quits for the night.

Jürgen

Settled in to room 527

Now begin the adventures in room 527. Judy made excellent progress today. At 1:00 she made the transition out of I.C.U., which is excellent!
She had two small complications that were quickly remedied. The motion of the transition made her nauseous, but a dose of nausea medication called Phenergen eased that nuisance. Later on in the day her oxygen intake got a little bit low, so they put her on 2L of O2. Her O2 and pulse rates have returned to normal and she is stable. More great news is that she took a step in physical therapy this evening. The therapist had her sit upright in a chair for thirty minutes! She did a great job. She also had many loving visitors this afternoon, all of which I have not been able to add to the list to the left because I have not yet figured out how to manage that function! Debbie, Toni, Wes, Father Jim, Cheryl and Fred Weber, Emily, Becky and Phillip all came to give their love to Judy today. She was so thankful for all of her visitors, but, in typical Judy fashion, she worries about anyone wanting to help take care of her because she doesn't want anyone to be bothered! Hopefully we can continue to show her that it's okay to be in the spotlight of love when she has "S" for Superwoman on her belly!
I could tell when I arrived this evening that she was tired from all the excitement of the day, so I gave her strict orders to SLEEP! So we're having a nice quiet evening. She is still groggy and loopy from the morphine, but she is as sharp as ever. She asked for lotion on her legs just now and told me exactly where her "Honeysuckle" scented lotion would be in her back pack. She's all there, just sleepy! Her voice is week too, a result of the ventilator tube from surgery. It's notieceabley stronger though since yesterday. Our strong woman is trudging along.
Thank you to all of for your love and support.

Saturday Midday: I.C.U LATER!!!

Yay for progress! The happy news just came from the nurse that Judy's new room is 527. Looks like we will be moving that way any minute, so just wanted to give all an update on the good news.
We also had a visit from Dr. Phillips the gynecological oncologist this morning. He checked out her incision and was happy with its looks. It is healing healthily.
The diuretic that Judy has been given helped make her pee more, so that got us the green light out of ICU and hopefully into a lakeside vista on floor five.
Dr. Phillips said that she'll be here about three or so more days to give her colon time to heal where it was reconnected after the dissection. She's still only allowed water and ice chips at this time, so we're crossing our fingers for the next step, juice and broth, before the colon is healed enough for solid foods and the ride home. I just heard her humor come out again when she asked the nurse for "chocolate cake water".
She is sweet and loving as the Judy we all know, with a kick in the pants now and then too. I'd never know she'd just had a giganti-normous surgery yesterday morning if it weren't for her affectionate morphine drawl.
She is in and out of cat naps, obviously bothered that she feels lazy and "no fun". I remind her that the drowsiness is normal, and that her body is just telling her it needs to sleep so the mind can focus on healing right now.
She has fun playing with the adjustable bed once in a while too. She figured out that her head can be raised and lowered to sit up or lay down. She sleeps with a sweet smile on her face, which I know comes from the assurance of love, hope, prayers, and encouragement she is getting from all of you wonderful people. Thank you so much for your love and support.
So, on to higher heights, as we climb from 304 to 527!

Saturday morning

Well, here you see our Judy in all her glory: Still in ICU, with the nausea-reducing pipeline to the stomach and a whole bunch of wires that are connected to machines that go "bing."

She spent a fairly decent night, with mild discomfort, at times some pain--heck, I'd be screaming bloody murder if they had opened me up the way they did her! She'd sleep for one hour, sometimes less, sometimes a little more, and then ask for a little water or ice, and then doze off again. Pain management is still a little bit of a problem because the morphine pump button that she can use to administer a small dose every 15 minutes gets lost among all those wires and tubes. She is also confused, thinking that the red heart-rate probe on her index finger should turn green, like the pump. But man, she is such a good sport about it all! she has not gotten frustrated one time yet.

For today, I have set up round-the-clock care by close friends for her since I will run up to Amarillo. Judy was supposed to be the chief referee for the Pain on the Plains mountain bike race, and she wanted me to take over. Judging how mad she got at me yesterday for not taking my break at the time that she had scheduled beforehand, she'd probably get up and kick me if I didn't go. She will be in the best hands!

We won't know when she will be moved to her permanent room, and because of the delay here in ICU she may not be in the preassigned room. The general number for Covenant–Lakeside is 806-725-6288.

J

A little bit more ICU, after all ...

Well, we all jumped the gun a little. Judy is going to stay in ICU overnight until Saturday morning because she—of all people!!!—has not been peeing enough. Her body is retaining a little extra fluid and she has been given a "water pill" via the IV to remove some of that.

So, we are staying overnight in her room in ICU. The nurse says she'll be moved to her room sometime in the morning.

Otherwise, there's quite a bit of discomfort that Judy is having, but she's still spunky and certainly bossed me around when I didn't take my break at the time that she had envisioned two days ago. Well, that's our Judy! Always thinking of others, never of herself.

Jürgen

Judy to leave ICU today

After three hours of what Dr. Phillips termed "very aggressive" surgery and needing three units of blood during surgery, Judy spent a calm night in ICU, according to the nurses.

She is still hooked up to a ventilator, just in case. She is breathing fine on her own, and the machine is just meant to assist if she needs it. From what I understand, those nasty-looking tubes will be removed today. Because of the tube she cannot speak. She is drifting in and out of sleep, with only about 10 to 15 seconds of full clarity before wandering off again.

She was obviously elated when I told her that taking out the affected section of her colon did not require a colostomy—she really had been worried about that. And she showed great relief over all the other news that I have been feeding her by-and-by. I don't know how much of what I have been telling her actually is going to stay in long-term memory, but I can tell the relief when she registers what I am saying.

She is not in very much pain; she indicated pain levels ranging from 0 to 2 on the scale to 10. She has a pain-pump (morphine) but has used very little of it. She is obviously bugged by the ventilator tube because she cannot talk, but she understands that it is necessary and is only temporary.

The nurse just changed the dressing on her incision, and I decided to watch. The incision is in a slight S-curve, a little less than about a foot long, starting right in the area where the rib cage opens and going maybe two to three inches below the belly button. The doc used staples, and the nurse was very happy with the way the entire area looked—no leakage, just a few small areas with some bruising, just really, really clean. On the inside, I was told, the doc used sutures to reattach the muscles that had to be cut. The nurse said that from the way the wound looks she would heal up fairly fast. Now I have a baseline to see how the healing process is coming along. Still, I don't think I'll enter the nursing profession anytime soon.

I also had a chance to talk to Dr. Phillips when he made his rounds this morning. It was at that time that he told me that he was "very aggressive." Yesterday he had mentioned that there was a 1 to 2 cm growth that he had not been able to remove, and I asked him more about it. He said that it was some growth in the Cecum area, in the vicinity of the appendix. To remove it he would have had to cut another, albeit small, piece of bowel and reattach the ends, and he did not want to take this risk. He is positive that chemo will take care of this area.

So, for right now we're just hanging out in ICU. Once we get out of here, Judy will be in room 519, with fine afternoon sun and a view of the lake in Maxey park. I am glad about Judy's high spirits, which are evidenced by a few thumbs-up and other little things that she has indicated with her eyes and the attempt at a smile—tough to do with all that tape that holds those tubes in place.

One final note: If you want to be notified when we post something new on this blog, you can "subscribe" to this blog by using the "Subscribe" button at the bottom of the page. There are some other subscribe options on the right side of the page, too. We don't want to inundate you and we want to really leave it up to everybody how much information you get. Of course, you can just come back and check periodically. Also, if you want to post a comment (and Judy will read and re-read all of them), you can do so without having a gmail account or anything like that. Just click on the "comments" link right below each post and a new window will allow you to write something and post it.

Once again, thank you for all your support.

Jürgen

Judy is out of surgery; things look positive--UPDATED

After a little over 3 hrs of surgery Dr. Phillips gave me the following update:

As suspected, Judy has Primary Peritoneal Carcinoma that has affected her body cavity. The colon was affected the worst and he had to remove a section approximately 10 to 15 cm long. This section was practically closed because of the tumor. He was positive that the dissection will not cause any long-term ill effects.

Cancer cells were spread over the omentum, presenting a thick layer. He was able to remove approximately 80% of the cancer cells, with the remaining 20% being smaller than 1 cm, except one 2 cm area that he hopes will respond to chemo. He expects to start chemo within 3 to 4 weeks. At this point it looks like chemo via IV instead of IP (via a direct port to the body cavity) because of the bowel dissection.

Judy will spend tonight in ICU as a precaution. She lost a fairly large amount of blood, but Dr. Phillips was very positive about the surgery and is very sure that she will recover fine from the surgery. He was equally optimistic about the chemotherapy and killing off the remaining cancerous cells. Any prognosis beyond that is out of reach at this point and academic.

He labeled her carcinoma as Stage 3c since it involved tumors of larger than 2 cm.

------------

Sorry to stop abruptly earlier but I wanted to get some info to you but then I had a chance to see Judy in ICU.

When I saw her, she was sedated and had a few tubes in her. The nurse said that everything looked OK and that she would be under full observation for the night. Judy was given 3 units of blood, which I assume is a pint each. The plan is for her to come out of heavy sedation tonight and be moved to her room sometime around midday tomorrow. I am spending the night at home to get a good night's sleep--not much I can do in ICU anyhow. The hospital is less than a 10-minute drive from home.

This was a long day, but I assume that scheduling works like this. Dr. Phillips smiled when I thanked him for his long day in surgery, and he said sometimes everything takes just a little longer than expected. I wish I could convey how positive he was about the outcome of the surgery and the prospects for the initial chemo--there seemed to be genuine satisfaction and relief emanating from him. Quite frankly, I had expected worse, stage 4, and maybe he did, too.

To all those of you who stopped by the hospital today (Becky O., Kathy and Walt, Becky and Phil, Toni, John, Don, Barbara, Alan and my wonderful buddy Wes), I can't tell you how much we both appreciate your support. To all of you posting comments here on the blog or sending an e-mail, let me tell you that I have either read your notes to Judy already or will do so once she comes off her unnatural high.

Judy finished today's tough stage of her race a little battered but, in the long run, with some nice prospects for the next few stages. You guys have been an unbelievable cheering crew. The race is on, as she says.

Jürgen

Still waiting

It is 7 p.m, and we're 3:15 hrs into surgery and I am waiting for the doc.

Thanks for the company of some very good friends who have made this wait much more bearable!

Jürgen

Surgery started at 3:45 p.m.

Judy was picked up to go into surgery at 3:45 p.m. That little woman is something--she wore out the first anesthesiologist and they had to get a new one. :) Seriously, it seemed like with the airline pilots that after too many hours on the job a new crew is called in. Quite frankly, we were happy with the change to Dr. Bijak as he seemed to be much warmer and more personal than the first one.

I briefly talked to Dr. Phillips who told me that he will see me after surgery. His entire demeanor was calm and confidence inspiring.

Judy was as ready as it comes after the long wait and not being allowed to have even a sip of water.

We have an assigned room--#519 here at Covenant-Lakeside. I am sure Judy will be out for the night when she returns from surgery. Of course, I will stay here all night. Expect an update later this evening.

Jürgen

Surgery delayed until 4 p.m.

We were just informed that it will be another 2 hours before surgery, so right around 4 p.m. We were told that Dr. Phillips is very thorough (fine with us!) and that he takes as much time as is needed, and things have been running a bit over time today. Judy is getting a little tired of lying around without even a sip of water, but we're OK. Just wanted to let everyone who is interested know what the status is here in Lubbock.

Also: I just learned that Blogger (yes, this program and website) will have a scheduled maintenance downtime this afternoon at 6 p.m. Central. The site should be back up after about 10 minutes, but who knows, this could be like surgery. :)

Jürgen

Update at 1:45 p.m.

The anesthesiologist came by to visit with Judy. Looks as if it won't be until 3 p.m. at the earliest that she will go in to surgery as there is one more patient ahead of her who is waiting just a few away. So, it will be a long afternoon.

Judy is getting tired of not being allowed to drink even a drop of water.

More later.

Jürgen

Morning of surgery

A quick update: We're at Covenant–Lakeside hospital. Judy is lying comfortably under a warm-air blanket, awaiting surgery. Right now two major surgeries are scheduled ahead of her, and the nurse tells us that she most likely won't start her surgery until 1:30 p.m. to p.m. at the earliest. So, that would also mean that I won't get to see Dr. Phillips until sometime around 5:00 p.m. or later.

Jürgen

Surgery is scheduled for tomorrow

We have just been informed that Judy will have to be at Covenant–Lakeside tomorrow morning at 7:30 a.m. She can expect to start surgery around 9:30 a.m., but as you know, that always depends on many factors. In our initial office visit Dr. Phillips had told us to expect a two- to three-hour surgery, but it could be longer or shorter, depending on the extent of the disease.

I will let y'all know as soon as feasible what Dr. Phillips tells me after he completes surgery.

So, tomorrow is the big day. We are ready, in no small measure because of your support.

Jürgen

Game is on, I am ready

Hello friends, family, and supporters,

I want you each to know that every post, email, warm thought, prayer, and/or phone call gives me one more ounce of strength. I am not afraid or anxious about tomorrow. Dr. Phillips has it under control. Jürgen is the one who will be a little stressed. I will be blissfully asleep.

I know that this is serious and will be difficult and dark at times, but I am ready. Jürgen or someone will read me the blog posts and they help.

I feel that through my faith and all the support that has poured out I/we will beat this.

Your support is humbling and a bit embarrassing, but as many of you have instructed me, this is the time for me to sit back and accept help.

Thank you again and I love each of you. I have gained new friends and realize what gems I already had in my life.

I will do this,
Judy

Counting down to surgery

After an almost "normal" weekend we've entered the countdown to surgery on Thursday. Our trip to OKC went very well, and Judy enjoyed working the race. She went out on the motorcycle, for the first time with a female driver who was about her size. You should have seen the two of them--they looked great.

This morning it's back to more lab work, and then another full day at MHMR. The e-mails and notes of encouragement keep coming in. On Wednesday we will know for what time the surgery will be scheduled on Thursday.

While in OKC we ran into our old buddy William whose wife is a OB/Gyn doc. He told us that the very first thing that Donna said when William read her the news of Judy's PPC, "If she gets Dr. Phillips, she'll be fine." You can imagine that we loved to hear that!

Saturday night we had dinner with some other friends, Terry and Leann, who is a "butt-and-gut" doctor herself. That wonderful dinner at their home gave us a chance to relax but also to ask lots of questions, especially since Leann's mother is fighting the same battle right now.

We are extremely fortunate to know so many people who are on our side.

Off to OKC

Wow, did Judy have a nice birthday yesterday--all those calls, e-mails, and cards were overwhelming. She's feeling spoiled! A big thanks to Wes and Susan for having us over for a simple spaghetti dinner, something that Judy not only loves (seriously, as a kid that was her favorite food) but can also digest right now. also a big thanks to Emily for being our chauffeur.

Today we're off to Oklahoma City to officiate the Redman Triathlon. This will be the last race for Judy until she has recovered from surgery, and she sure didn't want to miss this one. Even though it is a long drive to OKC from Lubbock, at this time of the year (and with the current perfect weather) it is always a pretty 6 1/2-hour drive once we hit the rolling hills east of Amarillo. We'll drop the roof of the Miata and will let the worries fly away.

Happy Birthday!

Happy Birthday, dear Judy! (even though you're not supposed to eat cake right now)

We have a game plan

We just finished up the first consultation with Dr. Benny Phillips, who specializes in gynecological oncology. Judy went into this meeting with three clear goals in her mind:

1. be accepted by Dr. Phillips as a new patient
2. be recognized by Dr. Phillips as not just another face but make a personal connection
3. come out with a clear idea of where we are going from here

All three objectives were accomplished.

The interfacing between physician and patient (and spouse) is so important, and I do not think we could be more pleased with today's development. Dr. Phillips took his time answering our questions, was frank in his assessment that we are facing a tough six months at the least, and showed more than the usual empathy one expects from somebody who sees patient after patient, year in, year out.

Here's the plan: Judy is scheduled for surgery for next Thursday, September 25, at Covenant Hospital–Lakeside here in Lubbock; we will be given the exact time next Wednesday. After surgery, called a cyto-reduction during which as much of the cancerous tissue as possible will be removed, she will face three to five days in the hospital. Thus we are expecting that she may come home the following Monday or Tuesday. The next six weeks will be spent mostly at home, with maybe some part-time work possible toward the end of that period. The cyto-reduction requires a fairly large incision as it is definitely a very invasive procedure, so lots of rest will be needed.

After her recovery from surgery Judy will start chemotherapy, as we expected. The length of these treatment cycles will obviously depend on various factors, but Dr. Phillips expects chemo to last several months.

We are thankful that we are not facing any prolonged wait and that we now have a clear idea of what the next steps are, even though they are practically identical to what we had surmised. Dr. Phillips' assessment was optimistic, even though he made very clear that this is a serious bout of Primary Peritoneal Cancer.

Judy had to go back to work after our 3 1/2 hour appointment but asked me to post this information. I am sure she will add some thoughts later.

Jürgen

Tuesday Evening

Gracias, Danke, and Thank You.

I am so touched by all of the wishes that I have received from everywhere, Chile, Germany, England, New Zealand, and of course all over the US.

All of you are important to me and I love reading your words encouragement. Some make me laugh, some are touching and some spiritually moving, but every single one gives me one more ounce of strength.

I am ready for tomorrow and I am eager to make a plan and start the fight. With each of you by my side I will win.

As my friend Ian Moore suggested, I will yell at this thing and kick it in the "you know where."

Prayers are great—I know they help. Good thoughts are strengthening and each one of your messages makes my day.

I now need to thank Jürgen. He is tender, kind, and the love of my life. He makes me eat, drink (no alcohol), and rest. I am not even cooking for him this week.



.

One match-point goes to Judy!

It may be just a small point, but it is one nevertheless: We were just informed that Judy's first appointment with Dr. Benny Phillips, her oncological surgeon, has been moved forward from Friday to this Wednesday, 1:45 p.m. We are sure that we have to thank the direct intervention of our friend Jewell, who is part of Lubbock's medical community and with whom we talked last night.

Judy is upbeat. She is ready to roll. The outpouring of support so far has totally overwhelmed her, but why would she be surprised? After all the good she has spread over her lifetime it couldn't be any other way. And that's not even counting the thousands of cookies!!!!

I took the photo on Saturday when Judy and our friend Emily went for their ride. We're trying to maintain as much normalcy as possible.

Jürgen

A different Sunday

We have just sent an e-mail to our many friends and acquaintances, letting them know about Wednesday's diagnosis. Jürgen and I are using this strange electronic tool that seems so impersonal because we know that in the weeks and months to come we will not be able to answer every e-mail and phone call immediately or with all the information that we'd like to include.

All this is new to us. Right now we are trying to adjust to the new reality. Nothing has really changed. I will go for a light bike ride with my friends Emily and Susan in a little while, and that will be fun.